You May Not Need Physio

There’s a condition, called CIPA, where suffers have a congenital insensitivity to pain. This incredibly rare inherited disorder of the nervous system may sound like a fairly appealing condition to have, but because sufferers don’t experience pain, they invariable end up sustaining severe injuries.

Take picking up a hot pan for instance. The immediate pain that’s provoked, results in you instantly dropping the pan. Whilst you may have still sustained a small burn, the severity of the burn would undoubtedly be significantly less than it would have been if you hadn’t experienced pain. The first warning sign people with CIPA would have experienced in that scenario would be the smell of their skin burning..

And the important point I’m trying to illustrate here is this: Pain is not simply a sign that injury has occurred, but also an important sign that injury is about to, or that persistence with a painful activity will lead to an even more severe injury. This concept is particularly relevant to some back and neck pain sufferers. Robin McKenzie, a World renowned New Zealand physiotherapist born in 1931, categorised all back and neck pain into three syndromes: Postural Syndrome, Dysfunction Syndrome, and Derangement Syndrome. Now, although many may challenge the simplicity of this categorisation, if people understood these first two syndromes, and how one leads to the other, a great deal of back pain could be avoided, as people could self-monitor and self-treat.

So, what is postural syndrome? Well, if I bend my finger backwards, initially it doesn’t hurt, but if I held it in this position for several minutes it would definitely start to. Let it go, and the pain goes, and no damage has been done. That is postural syndrome in a nutshell. If you sit, stand or lie in an awkward position for a prolonged period of time, you will eventually experience pain. Providing you address this, your pain will go, and you will not have sustained an injury that requires treatment.

However, returning to the bent finger analogy. If I was to repeatedly bend my finger backwards and hold it in this position for prolonged periods of time, day after day, week after week, the tissues on one side of my finger would become stretched and lengthened, whilst those on the other would become shortened and tight. Therefore, when I eventually let go of my finger, rather than it returning to it’s normal position, it would stop some way short of normal. And if I tried to move it beyond this new position, I would experience pain. And this is what’s called Dysfunction Syndrome.

We all have postural habits. Take me for instance. When sitting, I invariably cross my left leg over my right, and on the occasions when I try to switch I rarely switch for long, because it is significantly less comfortable. I’ve sat this way so frequently that structural changes have occurred. Similarly, whether sitting in an office chair, the car, or armchair, I will invariably lean to the left. The tissues along the left hand side of my spine will, as a result, have lengthened, and those on the right will have shortened.

Now, the question is, does this matter? Well yes, in that this is progressive; all the time you give in, and constantly assume the more comfortable position, you are reducing your pain free range. And, importantly, if you were suddenly forced to move into your painful tight range, you would be far more likely to sustain injury; with the tight tissues tearing due to inflexibility. So with me, for example, with my right side being my shortened, comparatively less flexible side, if I were playing sports and suddenly had to catch a ball high up to the right, I’d be significantly more vulnerable to injury than I would have been if I was equally mobile on both sides.

So, the message here is symmetry. Try not to favour one side, or one particular position. Watch for asymmetry and try to prevent such habits developing; ideally from a young age, whilst it’s still at the postural syndrome stage, before it develops into dysfunction syndrome. I guarantee if your child carries their rucksack over one rather than both shoulders, it’s always the same shoulder.. And I guarantee if you stand for a prolonged period of time you invariably relax one leg, bending the knee, dropping the hip, and it’s usually the same leg. Address these habits early enough and you will avoid dysfunction developing.

However, if dysfunction has already occurred, it is still highly treatable. With the correct program of stretches, strengthening exercises, and advise, symmetry can usually be restored, and your vulnerability to injury reduced. Obviously, if you live in London, the team at Physiotherapy London would be very happy to advise. But if not, to find a Chartered Physiotherapist near you who is trained in identifying and correcting such asymmetries visitwww.physiofirst.org.uk where you will find a directory of all the Chartered Physiotherapists in private practice in the UK today, and can search according to location. If you have any queries though, do just drop us an email, and we’ll try to point you in the right direction: enquiries@physiotherapy-specialists.co.uk

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Great service. Quick and friendly. Identified my issue quickly and after a couple of sessions provided the exercises I needed to get me back to full strength without the need for any further physio. Very much recommended.

I went for a 30 minute sports massage with Sophie Wicks today. I've had a problem with tight knots in my calves and I thought a massage pre-race would be a good idea. She applied good hard pressure on those knots unlike many masseurs and also gave me some post-run tips for loosening those muscles. Unlike many practitioners, she did not oversell and say that I needed a massage once a month or every week as I don't get many running related injuries. I will definitely be back.

These folk have been looking after me very well since 2007 through various sports injuries. They offer a comprehensive team of truly excellent specialists.Yet they are still small enough to be personal have a clear sense of who each client/patient is. The level of communication is first rate, as is attention to detail. Very convenient to get to from Canary Wharf.

I saw Milly Mirkovic for a sports related shoulder injury. I received excellent, expert professional care. Milly performed really detailed assessments at each appointment and set me tailored exercise programmes that were achievable. This got me back to normal fitness (and some!) in a reasonable timeframe. A couple of months along now and no recurrence of the problem. Many thanks.

I worked with Kasia Z. to deal with a torn elbow tendon, and I cannot recommend her enough. She was great to work with: patient, understanding and flexible. She gave me exercises to do at home to help speed the recovery process and was very responsive in tailoring them to my feedback as to what worked and what i was finding hard to incorporate into my daily routine. She not only helped me with the elbow, but gave me some great insights into my body, as well as recommending types of exercises I should focus on to prevent repeat injuries.

Following persistent pain in my knee, I saw my GP who recommended physiotherapy sessions.
I contacted Physiotherapy London (Canary Wharf) and got an appointment quickly and at a convenient time.
I saw a lower limb specialist who was very knowledgeable and friendly.
He took time to assess the problem, discussed with me various way of improving the condition and showed me in detail exercises I could do at home.
Very positive experience from the reception lady to the specialist.
Highly recommended.

My physiotherapist Candice is fab. I can't say enough great things about her and her professionalism. After suffering a trapped nerve and extremely painful scapula for nearly 8 weeks all the NHS would offer me was strong drugs, I was at my wit's end. I saw Candice, she gave me a comprehensive medical diagnosis as to what was causing the problem and has offered to refer me back into the NHS should a set schedule of regular treatments not rectify the problem.
I was dubious about going privately for treatment as money is tight, but this organisation seems to want to help. There is not a schedule of endless appointments and the prices are reasonable. The condition is improving slowly and I feel better in myself knowing what caused it and that I am in safe hands going forward.
Thank you Candice.